| Susan Lee | |
|
790 E Santa Clara St Ste 110 Ventura CA 93001-2957 | |
| (805) 701-2048 | |
| Not Available |
| Full Name | Susan Lee |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 790 E Santa Clara St Ste 110, Ventura, California |
| Authorized Official Name and Position | Susan Lee (OWNER/LCSW) |
| Authorized Official Contact | 6093382244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Lee 2419 Harbor Blvd Ste 143 Ventura CA 93001-3904 Ph: (805) 701-2048 | Susan Lee 790 E Santa Clara St Ste 110 Ventura CA 93001-2957 Ph: (805) 701-2048 |
| NPI Number | 1053067314 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 05/03/2022 |
| Certification Date | 05/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053067314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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